1215233457 NPI number — MONICA RESTREPO JONES L.M.T., M.M.P.

Table of content: MONICA RESTREPO JONES L.M.T., M.M.P. (NPI 1215233457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215233457 NPI number — MONICA RESTREPO JONES L.M.T., M.M.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
MONICA
Provider Middle Name:
RESTREPO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.M.T., M.M.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RESTREPO
Provider Other First Name:
MONICA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT, MMP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215233457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 LAKE HAYES RD
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
OVIEDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32765-9097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-314-0396
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 LAKE HAYES RD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
OVIEDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32765-9097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-314-0396
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA48008 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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